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Home My WebLink AboutBuilding Permit #597 - 275 DALE STREET 4/15/2008 BUILDING PERMIT o*"°RT 6�ti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION h Permit NO: Date ReceivedArOD �9SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Q-2 `J D A L� S'►(Z��'" Pri t PROPERTY OWNER �ATZI C N M ON 9Print MAP NO:.a)(3 PARCEL:ZONING DISTRICT:O0a-s Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE R Non- Residential New Building One famil Addition Two or more family Industrial Alteration No. of units: Commercial epair, replacement Assessory Bldg Others: Demolition Other Septic ell Floodplain Wetlands Watershed District ater/Sewer DESCRIPTION OF WORK TO BE PREFORMED: _ N 9 9�—l2 �z /40 Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name:,RONvKkA g �,f Nocc )Aa �2 Phone: q-2%- b5 6-7 I ), Address: I" �� ►-')i2& -NtirA� 214-tt M0 - {� &bJF2 Y-1)0 oIZLrf Supervisor's Construction License: 07-7-6L4 Lf Exp. Date: la3 30o? Home Improvement License: 1'4 I 3,o;z, Exp. Date: i a r a,01 Q I ARCHITECT/ENGINEER ti Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASES ON$125.00 PER S.F. Total Project Cost: $ M .�(� �00� FEE: $_T? Check No.: a Baa— - Ai Receipt No.: O NOTE: Persons contraMnh gistered contractors do not have ac ess t l arantyfund ignature of AgenVOwnSignature of contracto LocationS�— No. Date NORTH TOWN OF NORTH ANDOVER � R 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee r$ Other Permit Fee $ TOTAL $ Check # Building Inspector ed Plans Plans Submitted Plans Waived Certified Plot Plan Stamped TYPE OF SEWERAGE DISPOSAL Swimming Pools Public Sewer Tanning/MassageBody Art Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONSOFFICE- U FORM E ONLY INTERDEPARTMENTALSIGN OFF DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Si nature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con necti on/S ig nature &Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood Street FIRE DEPARTMENT Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date ■ COMMENTS Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL i Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales ` Private(septic tank,etc. Permanent Dumpster on Site � I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT } COMMENTS 1 CONSERVATION Reviewed on Signature } 4 COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood Street i FIRE DEPARTMENT - Temp Dumpster on site yes no-'\ Located at 124 Main Street Doc.Buil Fire Department signature/date COMMENTS _ - �A�tbe apPea`rea 1hol tmustbesubm�tt ERVICESD�Y�TM� . DpV 11`1SY_CT�OnAI S Remised 2 2008 d Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use II `I i i ❑ Notified for pickup - Date .... ................. Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of.H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENTMFORM07 Revised 2.2008 NORTH Town of Andover 0 No. kT, 77 LA 0dover, Mass.,/ 0 COCHICHEWICK 11. C OOATED BOARD OF HEALTH Food/Kitchen PERMIT- T D Septic System 10 06 - BUILDING INSPECTOR THIS CERTIFIES THAT ....A.... Aj.e%o ........I .. . .............................................................. . . ............................................................. Foundation has permission to a buildings and %1 ........44--.0w.... Rough ................................... . . ....... to be occupied as.... A00C.................... (!r"mney ................ . provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU Rough ............ .... .................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE.�j Smoke Det. MacDonald & Pangione Insurance Agency, Inc. 104 Main Street North Andover, MA 01845 Phone 978-688-6921 Fax 978-688 5350 April 14, 2008 R & M Carpentry & Ron Finocchiaro 165 Marblehead St No Andover, MA 01845 TO WHOM IT MAY CONCERN: Ron Finocchiaro has applied for Workers Compensation coverage through our office and has been assigned to Liberty Mutual effective April 11, 2008 - see copy of print out from the Workers Comp Pool. Sincerely, Marguerite Nelson Commercial Lines Account Manager MacDonald.& Pangione Insurance Agency, Inc. /mn WCRIBMA :: MWCARP Application Status Search Page 1 of 1 WCRIBMA ::MWCARPApplication Status Search Data Last Updated 4/11/20o810:15:07AM MWCARP Overview Producer Community Home Select either the employer's NAME or the employer's FEIN number to search. (7) Employer's Name () FEIN-Fed.Emp.ID# 432056899 NOTICE: By accessing this section of the Bureau's web site,you accept and agree to the terms and conditions for use that are set forth throughout this web site. STATUS key reference-CARRIER NUMBER key reference Tentative . Client StatusEmployer Name Address Status Carrier Date Date Number R&M CARPENTRY LLC 165 MARBLEHEAD ST 0783644 04/10/08 04/11/08ASSIGNED 04/11/o8 15628 N ANDOVER,MA o1845 https://www.wcribma.org/mass/Producer/ApplicationStatusSearch/StatusSearchPage.aspx 4/11/2008 WCRIBMA :: Producer Community - Pool Carriers Page 2 of 2 (800)645-2259 FAX(973)33i-8534 10456 VDAC Hartford Underwriters Insurance Company (TPA 80411) Direct Assignment Operations P 0 Box 4903 Orlando FL 32802-4903 (800)453-9843 FAX(877)634-3710 16586 Servicing Liberty Mutual Fire Insurance Company* Involuntary Market Operations P 0 Box 9o90 Dover NH 03821-9090 (800)653-7893 FAX(603)334-8162 *Address and fax*change effective 11/02/2007 15628 VDAC Liberty Mutual Insurance Company* Involuntary Market Operations P O Box 9o90 Dover NH 03821-9090 (800)653-7893 FAX(603)334-8162 *Effective January 1,2oo8 31771 VDAC Savers Property&Casualty Insurance Company* Ms.Amy DiBari 981 Worcester Street Wellesley MA 02482 (800)514-2667 FAX(877)280-2446 *Effective.January 1,2oo8 11347 Servicing Travelers Indemnity Company Residual Market P O Box 3556 Orlando FL 32802 (800)443-4404 FAX(877)634-3710 13579 VDAC Travelers Property Casualty Company of America Direct Assignment Operations P 0 Box 3556 Orlando FL 32802 (800)443-4404 FAX(877)634-3710 https://www.wcribma.org/mass/Producer/poolCartiers.aspx 4/11/2008 ' The Cormmoizwealth of Massachusetts Department of Industrial Accidents — Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): C ^ �� L C Address: 16-6 to t,2�.2U f, ( J� City/State/Zip: I�(� , A,, Phone#:_o•j Are you an employer?Check the appropriate box: 'Type of project (required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6 E]New construction employees(full and/or part-time).* have hired the sub-contractors 2 I am a sole proprietor or partner- listed on the attached sheet. 1 7• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. workers' comp, insurance. 9 ❑Building addition [No workers' comp, insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ of repairs insurance required.] t employees. [No workers' comp. insurance required.] 13. 0ther_��,,-, *Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contmctors must submit a„e,_,affidavit indicating such. ,Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. .Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-ye r pnsonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250. ay against th vi a or. Be advised that a copy of this statement may be forwarded to the Office of Investigaf ns of the r r in n e overage verification. I do her by certif u d r e ains a penalties of perjury that the information provided above is true and correct. Si nature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official. City or Town:_ Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACORD CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YY) 04/09/2008 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MacDonald & Pangione Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 428 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 104 Main Street North Andover, MA 01845 INSURERS AFFORDING COVERAGE INSURED R& M Carpentry ry INSURERA: Preferred Mutual Fire Insurance Company Ron Finocchiaro INSURERB: Safety Insurance 165 Marblehead St INSURER C: j No Andover, MA 01845 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR DATE MM/DD DATE MMIDD LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY CPP 0150 56 51 46 12/06/2007 12/06/2008 FIRE DAMAGE(Any one fire) $ 100,000 CLAIMS MADE k]OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PE� LOC AUTOMOBILE LIABILITY 2980424 03/31/2008 03/31/2009 (Ea acct idea SINGLE LIMIT $ ANY AUTO 1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR n CLAIMS MADE AGGREGATE $ ]DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION ANDSTATU- OTH- EMPLOYERS'LIABILITY TORWC Y LIMITS ER E.L.EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE $ OTHER E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder as listed below CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN AttTown of North Andover NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL No Building Inspector IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR No Andover, MA 01845 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25-S(7/97) 0 ACORD CORPORATION 1988 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:-:. 141202 Exp�rat�on 1/21/2010 Tr# 262483 TYPe Ltd:Liability Corpor R+M CARPENTRY LLC.' RONALD FINOCGHIARO:.;._. 165 MARBLEHEAD STS ` N.ANDOVER,MA 01845 Administrator '�'' BOARb OF BUIL.-DING REGtJLATlQNStii r ' ' License: 6E3(VSTRUCTK NSUPERUiS:OR Number CS 077344` birth- Ex, irtis- 07/23/1967 Expires 07/23/20011. Tr.no: 29099 Restricted 00 RQNALD E FINOCCHIARO-i. r, . 165 MARBLEHEAD ST N ANDOVER, MA 01$45 Commissioner �', I R & M Carpentry LLC. 165 Marblehead Street No. Andover, Ma 01845 (978)-794-2446 Pat Money 275 Dale Street No. Andover, Ma.01845 Easement Remodel R& M Carpentry LLC is responsible for the following basement remodel at the Address of 275 Dale Street No. Andover, Ma.01845. R&M Carpentry is responsible for scheduling of sub-contractors, construction material, permit for remodel, and disposal of all construction debris. All work performed will meet local and state building codes. Any unforeseen or additional work will subject to a change order agreed by R&M Carpentry and the home owner. Basement Segment Frame 2x4 walls according to basement layout and design. Install a suspend ceiling system in basement area. Install cabinetry with counter, Electrical and plumbing, closet doors and office door unit. 2x4 wall framing @ 16"o.c with p.t bottom plate fasten to concrete floor Install R-11 wall insulation with vapor barrier Install 1/2 "blue board with plaster finish(smooth)to new basement area and storage area Install 2x4 suspended ceiling systems in basement area and storage area Install oak cabinetry base units and upper cabinet according to plans Install laminate counter top according to plans with sink cut out Cont: Install(2) 4' bi-fold closet door units to closet area Install plywood shelves in closet area and in storage area Install(1) 3' French door unit to office area Trim(1) existing window unit Install colonial base trim around bottom of wall area Install custom bench seat with open top and coat hooks Install ceramic the to floor area at garage entrance Tiles install only, Tile and grout supplied by home owner Install indoor carpeting to new basement area and existing stairway Install oak newel post with oak hand rail with white baluster on existing stair way Electrical segment Install wall outlets and light switches in basement area according to code Install GFI outlet at counter top area Install 2x4 fluorescent lighting in suspend ceiling according to plans Install power to sewer ejection Install smoke detectors according to code Plumbing segment Concrete cut to floor area for sewer ejection unit I CONT: Plumb segment . Install sewer ejection unit for sink drain Install a stainless sink unit with faucet Connect new sink to existing drain system Install baseboard heat according to room design All work listed above are in the total cost for the basement remodel. Basement remodel $39,595.00 Payment schedule Schedule work on R&M Carpentry work schedule $ 1,900.00 Start work, order material $ 11,095.00 Rough inspections (frame,electrical,plumbing) $9,000.00 Wall plastering and installation of finish work $10,000.00 Balance due on final inspection $7,600.00 Home o -Ronald Finocchiaro ,r mem er M C R& krpentry- C__ 165 Marblehead Street No.Andover,Ma01845 ,8� -W7 ra ; r 1,7-z ..�00��3`J�?tols ,b iy u .� ti ice" 1 ,v �•<. � _._.._._ i _ �A -